As part of the IHSS program, protective supervision is available to individuals who require 24/7 adult supervision to prevent injury to themselves or others due to severely impaired judgment, orientation, and/or memory.
Protective supervision is awarded for recipients who are non-self-directing and whose risk of harm to self or others is due to their severe cognitive impairment. Non-self-direction is defined as “an inability, due to a mental impairment/mental illness, for individuals to assess danger and the risk of harm, and therefore, the individuals would most likely engage in potentially dangerous activities that may cause self-harm.”
Protective supervision will not be awarded for intentionally self-injurious behavior, intentional violence to others, or damage to property. While protective supervision is not available in anticipation of a spontaneous medical emergency due to a known medical condition, supervision may be awarded if the recipient requires constant supervision to prevent the removal of life-sustaining devices because the recipient doesn’t understand the consequences of their actions.
Some counties may ask applicants to fill out a form that asks about self-directed behavior without naming it directly, for example asking if the child's behavior is a way to achieve a desired result. Public Benefits Specialist Lisa Concoff Kronbeck says that you may want to ask your child's doctor to draft a written answer and attach it, explaining that the behavior may be aimed at achieving a simplistic goal such as sensory input or access to a preferred toy, but the patient is unable to assess the risk of potential injury before engaging in the behavior. You could attach ACL 15-25 specifying that for IHSS purposes, self-directing behavior is explicitly about the ability to evaluate risk before acting, not about trying to achieve a desired result.
For more information, see our full article on IHSS protective supervision.
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